6.Define the term insulin resistance. Explain the relationship between insulin resistance, obesity, exercise, and noninsulin-dependent diabetes mellitus.
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Alexandra, without getting too high complex, type 2 diabetics develop insulin resistance as their target organs repond less and less to insulin (less uptake of glucose by various organs), thus keeping serum glucose levels way higher. This certainly happens over quite a duration. I don't know the exact pathophys. of how obesity directly increases insulin resistance or leads to development of DM2, but we know that adipocytes have endocrinologic factors that likely play a role in this. In non-insulin dep. DM2, we have various agents that can either increase the secretion of insulin by the pancreas or more novel agents which also have the capacity to decrease end-organ insulin resistance, i.e. make target organs more sensitive to insulin.
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